State Health Insurance Marketplaces

CMS final rule improves access to Affordable Care Act marketplace coverage

April 3, 2024 - CMS has finalized policies to increase access to marketplace coverage and expand essential health benefits (EHBs) in the HHS 2025 Notice of Benefit and Payment Parameters final rule. “Access to affordable, quality health care options remain a concern across the country and a top priority for CMS,” CMS Administrator Chiquita...

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4 Barriers to Coverage Among Uninsured Individuals in Massachusetts

by Kelsey Waddill

Uninsured individuals in the state of Massachusetts face a variety of barriers to healthcare coverage, including real and perceived eligibility gaps and a complex health insurance landscape, a report...

Potential Outcomes of Basic Health Programs for States, Consumers

by Kelsey Waddill

Basic Health Programs (BHPs) can streamline coverage and increase coverage continuity for certain populations, but the cost to states will vary, a report from the Urban Institute shared. “The...

The Role of Affordable Care Act Premium Tax Credits in the Payer Industry

by Kelsey Waddill

The Affordable Care Act marketplace premium tax credits were introduced in 2010 and continue to play an integral role in US health insurance. A Google search on premium tax credits will demonstrate...

CMS: 15.9M Enrollees Have Selected ACA Marketplace Plans for 2023

by Victoria Bailey

Nearly 16 million people have enrolled in Affordable Care Act (ACA) marketplace plans since the 2023 marketplace open enrollment period began, including 3.1 million new enrollees and 12.8 million...

Outreach from State-Based Marketplaces Increased 2022 ACA Enrollment

by Victoria Bailey

State-based marketplaces employed several outreach methods during the 2022 open enrollment period to boost health plan enrollment among uninsured individuals, including data-based efforts and...

NY Anticipates the Impact of Ending the American Rescue Plan Act Flexibilities

by Kelsey Waddill

The American Rescue Plan Act established enhanced tax credits that boosted New York’s state health insurance marketplace enrollment, but the end of those tax credits could lead to a spike in...

How States Can Improve, Increase Race and Ethnicity Data Collection

by Kelsey Waddill

Affordable Care Act marketplaces could play a crucial role in race and ethnicity data collection,  but may states are failing to collect such information, according to a blog post from...

4 ACA Marketplaces Take Action to Advance Health Equity

by Mark Melchionna

California, Connecticut, the District of Columbia, and Massachusetts pursued different Affordable Care Act marketplace strategies in order to improve health equity for underserved populations,...

Trends in Medicaid MCO, Marketplace Network Adequacy Standards

by Victoria Bailey

In general, Medicaid managed care organizations (MCOs) have better provider network adequacy standards at the federal level than marketplace qualified health plans (QHPs), but standards varied...

State-Based Marketplace Premiums to Increase Without ARPA Expansion

by Victoria Bailey

If federal officials do not extend the enhanced premium subsidies under the American Rescue Plan Act (ARPA), state-based marketplace enrollees will face higher premiums and may lose coverage in 2023,...

CMS Updates Affordable Care Act, Public Payer Enrollment Numbers

by Kelsey Waddill

CMS has released the latest 2022 enrollment data for the Affordable Care Act marketplace and the most recent 2021 public payer enrollment data for Medicare, Medicaid and Children’s Health...

ACA Marketplace Open Enrollment Sees 4.6M Enrollees So Far

by Victoria Bailey

Nearly 4.6 million individuals have signed up for 2022 healthcare coverage since the start of the Affordable Care Act (ACA) marketplace open enrollment period, the Department of Health and Human...

How COVID-19 Impacted The Individual Health Insurance Marketplace

by Kelsey Waddill

The individual health insurance marketplace saw changes in enrollment and in enrollees’ healthcare spending risk as a result of the coronavirus pandemic in 2020, a Health Affairs study...

CMS: KY, ME, NM Will Launch State-Based Marketplaces in 2022

by Kelsey Waddill

Three states will launch their own state-based marketplaces in 2022, the Department of Health and Human Services (HHS) announced through CMS. Kentucky, Maine, and New Mexico will each bring have their...

Affordable Care Act Marketplace Sees Boost in Diversity, Savings

by Kelsey Waddill

HHS has announced that 2.8 million people gained health insurance coverage through the Affordable Care Act marketplace during the special enrollment period. This influx of enrollees raised marketplace...

Public Option Health Plans Continue to Progress at State Levels

by Victoria Bailey

Efforts to create a federal public option health plan may have stalled, but public options on the state level are slowly emerging, according to a Manatt Health mid-year update. While President...

Two Critical Impacts of 2021 Special Enrollment Period Gains

by Kelsey Waddill

The 2021 special enrollment period gains on the Affordable Care Act (ACA) marketplaces could have downstream impacts on enrollment-related factors such as customer service investments and risk...

CMS Supports Modernizing Enrollment on State-Based Exchanges

by Kelsey Waddill

CMS is offering $20 million in grants to states in order to update their state-based exchanges in light of the spike in Affordable Care Act marketplace enrollment. “Our State-based Marketplaces...

Nevada Set to Become Second State with Public Option Health Plan

by Kelsey Waddill

The state of Nevada could become the second state to embrace a public option health plan, if the governor signs SB420. “Section 10 requires the Public Option to be available through the Exchange...

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